Indiana’s Medicaid experiment offers a conservative take on health reform – LA Times

Pete Sheehey’s plan to expand Medicaid: “They would pay what it’s costing Medicaid to cover them, and they would get that coverage…I believe that Medicaid is covering people at a lower cost than any of these private insurance companies that are offering policies.” Obamacare already expanded Medicaid from only children, mothers, and the disabled to include low-income, working-age adults, costing taxpayers more than $500 billion/year. Can we really afford to expand it even further? We need Medicaid reform, not Medicaid expansion!

Though the coverage has provided a vital safety net, Medicaid faces challenges. Patients often fare worse than privately insured Americans. And 21 states, mostly in the South and interior West, have refused to expand their programs, citing concerns about Medicaid’s effectiveness and cost.

“For us to be honest, we have to say that the Medicaid program is … in need of fixing,” said Vernita Todd, chief executive of Heart City Health Center, which operates two clinics in Elkhart serving patients who are uninsured or on Medicaid.

Todd, like many officials who work with Medicaid, has labored to get patients to checkups and other preventive care. “What we have learned is that our Medicaid population is not really very health-literate,” she said.

For years, states have tried to nudge patients to make better choices. One strategy has been to make Medicaid look more like private insurance, charging premiums, co-pays and penalties for emergency room visits.